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"good" CD4 percentage
Apr 7, 2009

Hello Dr.! What's a good cd4 % for someone on pegINF/ribavirin HCV therapy? And what's the minimal CD4 count to start the treatment? Thank you!

Response from Dr. McGovern

There are no clear cutoffs for CD4 percentages and treatment. I will say that my main concern is to have a patient on good HAART with viral suppression of their HIV as a main starting point. If the CD4 percentage is 15% or higher that would be best.

If the patient has advanced liver disease, then I will likely give a trial of therapy and will check their HCV RNA levels after 4 and 12 weeks of therapy. I will get a clear idea from the viral load decline how the patient is doing. This to me is the most important parameter to follow. The CD4 counts don't always predict the response as has been shown in some large trials.



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